Patient Care
Admission Process
What happens between the doctor deciding that a patient must be admitted and the patient reaching a bed — the paperwork, the room choice, the deposit and estimate, and the questions worth asking first.
How an admission starts
An admission begins with an admission advice note written by a consultant — either in the outpatient department, or in the emergency department when a patient arrives acutely unwell. The note states the provisional diagnosis, the speciality under which the patient is being admitted, and the level of care required: general ward, private room or an intensive care unit.
That note is what the admission counter works from. Everything else — bed allotment, estimate, insurance pre-authorisation — follows it. In an emergency the sequence is reversed: the patient is treated first and the admission formalities are completed by the attendant while treatment is under way.
One family member should be nominated to handle admission formalities and to be the point of contact for the treating team. Splitting this between several relatives is the single commonest cause of information going missing between a hospital and a family.
From the admission advice note to the bed
- Admission advice note issued
The consultant records why admission is needed, under which speciality, and the expected level of care. Ask at this point how long the stay is likely to be and what the plan is — a rough answer given honestly is more useful than no answer.
- Reporting to the admission counter
Carry the advice note, the patient's photo identity, the hospital identification number, and insurance or TPA card if applicable. Bed availability in the required category is checked here.
- Choosing the room category
The counter explains which categories are available and how the choice affects the bill. Room category affects not only the room charge but often the associated charges for nursing, consultant visits and procedures, so ask for the effect on the total, not just the daily rate.
- Written estimate and admission deposit
For a planned admission you should be given a written estimate of the likely cost based on the diagnosis and planned procedure. An admission deposit is collected against it. Ask what the estimate excludes — implants, high-end antibiotics, blood products and intensive care escalation are the usual exclusions.
- Insurance desk
If you intend to use cashless insurance, go to this desk before or immediately at admission. Pre-authorisation takes time and cannot be applied retrospectively to a bill already settled in cash.
- Consent and admission forms
General consent for admission and treatment is taken, along with specific consent for any planned procedure, anaesthesia, blood transfusion or high-risk intervention. Read what you sign and ask for it in a language you follow.
- Identity band and bed allotment
An identity band is placed on the patient's wrist and the patient is shifted to the allotted bed. The ward nurse records the admission, checks the medicines brought from home and orients the attendant to the ward.
- Handover to the treating unit
The ward doctor examines the patient, confirms the plan and writes the initial orders. Ask the nursing station which consultant is primarily responsible for the case and when the daily round is expected.
Room categories — what usually differs
Categories and their availability vary; confirm the current list, the tariff and what each category includes at the admission counter on the day.
| Category | What it usually means | Worth considering |
|---|---|---|
| General ward | Shared accommodation with several beds, curtain partitions and a common nursing station. | Lowest cost and closest nursing observation. Limited privacy and usually one attendant only. |
| Semi-private room | Two beds sharing a room and washroom, with attendant seating. | A compromise between cost and privacy. Attendant space is limited. |
| Private room | Single room with attached washroom and attendant space. | Better rest and privacy. Room category may raise the rate applied to other charges. |
| Deluxe or suite | Single room with additional attendant facilities. | Most expensive category; rarely necessary on clinical grounds. |
| Intensive care unit | Monitored bed with ventilator capability, invasive monitoring and a resident doctor on the floor. | Allotted on clinical need, not on request. Visiting is restricted and attendants stay outside. |
| Isolation bed | Single room used for infectious conditions or immunocompromised patients. | Extra precautions apply for staff and attendants; gowns and masks may be mandatory. |
Deposit, estimate and how the money actually moves
- An estimate is a considered projection, not a quotation — the final bill can differ if the clinical course changes, and it usually differs upward rather than downward
- The admission deposit is adjusted against the final bill; it is not an additional charge
- For stays beyond a few days, interim bills are generated so that the balance does not accumulate into a shock at discharge — ask for one at any time
- If a change in the plan will significantly increase the cost, the treating team or the billing desk should tell you before it is incurred; ask to be told
- Under cashless insurance the insurer settles the approved portion directly, and you pay the non-payable portion, the deductible or co-payment, and anything the policy excludes
Attendants, passes and identity
- One attendant is generally permitted to stay with a ward or room patient; intensive care patients do not have an attendant at the bedside
- Attendant passes are issued at admission — carry the pass and be prepared to show it at the entrance, particularly at night
- Nominate one attendant as the point of contact for the treating team, and let that person relay information to the rest of the family
- The patient's identity band must not be removed, cut or covered until discharge; staff check two identifiers on it before every medicine, sample, transfusion and procedure
- Tell us immediately if any detail on the band is wrong — a wrong name or number is a safety problem, not a clerical one
- Keep valuables, cash and jewellery at home; the hospital cannot take responsibility for personal belongings kept at the bedside
Questions worth asking before you sign anything
- What exactly is being treated, and what is the aim of admission?
- Which consultant is primarily responsible, and when is the daily round?
- How many days is the stay likely to be, and what would extend it?
- What does the written estimate include, and what does it deliberately exclude?
- Is any implant, device, blood product or high-cost medicine expected, and what does it cost?
- Is this procedure covered by my insurance policy, and has approval been obtained?
- What are the risks of the planned procedure, and what is the alternative if we decline it?
No hospital charge is ever collected outside the billing counter, and no legitimate payment is made to an individual in a corridor. All payments must be made at the billing counter against a printed receipt. If anyone asks you for money outside that process, or offers to arrange a bed or a faster appointment for a consideration, report it to the duty manager immediately.
Not sure which department you need?
Share your symptoms and the appointment desk will route you to the right consultant. For anything sudden or severe, do not wait for a callback — come to the emergency department.